<原著>虚血後心筋収縮障害と冠側副血流

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This study was investigated the relationship between coronary collateral flow and myocardial contractile reserve estimated by postextrasystolic potentiation (PESP) in 13 open-chest dogs. The left anterior descending coronary artery was occluded for 15 minutes and reperfused for 240 minutes. Regional myocardial blood flow (RMBF) was measured using nonradioactive colored microspheres before and at 7 minutes after occlusion, as well as at 30,60 and 240 minutes after reperfusion. Regional myocardial shortening was measured using ultrasonic crystals. During occlusion, RMBF was markedly reduced, but there was a considerable amount of flow, which was probably supplied by collaterals, to the ischemic myocardium. Systolic shortening (%SS) was reduced by coronary occlusion. The dogs were classified into the following 3 groups according to percent of control RMBF during coronary occlusion : group L, RMBF 2O% or less ; group M, 21 to 7O% ; and group H, 71% or more. In group L, %SS increased from 2O.8±l.7% to 30.9±2.5% upon PESP before occlusion, while upon PESP for 5 min and 60 min after reperfusion it increased from 12.9±2.1% to 27.5±1.8% and from l4.2±1.9% to 32.0±1.8%, respectively. Before coronary occlusion, %SS with PESP and that without PESP showed high positive correlation (r=0.86,p<0.002). Fifteen minutes after coronary reperfusion, the ratio of %SS with PESP to that without PESP was inversely correlated with collateral blood flow (r=-0.45,p<0.05). In conclusion, increase of the systolic shortening by PESP was influenced by the degree of collateral flow during ischemia. In stunned myocardium, the contractile reserve induced by PESP was greater with low collateral flow than in with high flow.
近畿大学の論文
1992-03-25

著者

石田典裕
近畿大学医学部第1内科学教室

<原著>虚血後心筋収縮障害と冠側副血流

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